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Child health

Investing in the Future of Children in Multicultural Australia  -  Cultural Competence in Families First (CULCOFAM)


Eisenbruch, M., Vimpani, G. (Newcastle), Alperstein, G. (Sydney)., Phung, H. N (SWSAHS), Flores, G. (Milwaukee), Nossar, V. (Adelaide)
Australian Research Council, DP0559813, ($405,000)

The Cultural Competence in Families First project (CULCOFAM) aims to discover how to promote the development of children in multicultural Australia by answering three questions: In what ways do cultural values and traditions about parenting brought by Cambodian families help their children’s development? How can health workers tap into traditions to help these children to grow in good health? How will this process help immigrant families become stronger as a community and as Australians? Fieldwork will be carried out with Cambodian families to highlight issues from the viewpoint of parents, families, community, and health workers who look after children.

The project aims to create a framework for cultural competence in child health in multicultural Australia. Its three objectives are to:

  1. Explore how the culture borne by CALDB parents shapes parenting and can enrich development of their children in Australia. In short, to identify the ‘cultural capital’ of parenting

  2. Explore how an understanding of the cultural capital of parenting could enhance the cultural competence of Australian child health services to harness culture for health and, in turn, improve parenting as a prerequisite for improvement in life chances of children of CALDB.

  3. Identify the potential for this culturally competent system, through giving value to cultural capital, to strengthen social cohesion and community harmony of families within Australian society

Participant observation is being carried out with key informants such as Buddhist monks and the elderly women who are key ‘opinion makers’ about childrearing. They are contacted through snowball strategy. The attributions of childhood health and illness are recorded. These encounters create entry points for observation of day-to-day parenting routines and trigger natural discussion about parenting procedures and childhood behaviours; elicit the family understanding of child health workers’ accounts; their appraisal how well the health worker heard their concerns and understandings; how cultural issues were negotiated with the health worker; what they feel should be discussed within the health encounter and what is more appropriate elsewhere, with whom, and when and how should it be raised; and why they felt this way.

2005-07

2005 :   $160,000
2006 :   $115,000
2007 :   $130,000

2005
Cultural competence in early childhood intervention programs
Eisenbruch, M.
Telstra Foundation Community Development Grant, $50,000

Families First - Towards cultural competence in Families First:  Improving the health and well being of children and families of culturally and linguistically diverse backgrounds

Researchers: Michael Kakakios, (NSW Health), Gai Moore (SWSAHS); Ilona Lee (NSW Multicultural Health Communication Service); Maureen Belanszky (SWSAHS Families First), Maurice Eisenbruch

NSW Health, and Cabinet Office, $670,000
2002-

The Project responds to evidence of the needs of children, mothers and families of CALD backgrounds in accessing appropriate support and services. Based upon an understanding of cultural determinants on parenting, a model for cultural competence in Families First was developed and evaluated. Based upon an understanding of cultural determinants on parenting, a model for cultural competence in Families First is being developed and evaluated. The project explored three questions:

  • In what ways do the cultural values and traditions about parenting brought by immigrant families help their children’s development?
  • How can health workers tap into such traditions to help these children to grow in good health?
  • How will this process help immigrant families to become stronger as a community and as Australians?

Cultural competence was developed in relation to

  • Communication strategy;
  • A culturally validated psychosocial assessment tool for mothers;
  • A sustained home visiting intervention;
  • A bilingual early parenting program for new and emerging communities;
  • Support providers in maternity, child and family health services;
  • Evaluation tools.

Relevance to National Priorities: A healthy start to life – Finding out how immigrant parents from culturally different backgrounds bring valuable parenting knowledge will help to overcome social factors which reduce the children’s well-being and life potential. This supports the National Agenda for Early Childhood initiative. Preventive healthcare – Developing guidelines for culturally appropriate promotion of healthier parenting, will strengthen capacity to stop children getting sick. This supports the Focus on Prevention Initiative. Strengthening Australia’s social fabric – If we understand the traditional support structures of immigrant families, we can ensure that our services help them make culturally acceptable choices so they look after themselves. This supports the national welfare reform and participation agendas.

Nutritional studies of Vietnamese children

Allen, J. et al., (Fairfax Institute), and Eisenbruch, M. - Associate
Financial Markets, $50,000

Thick milk and robust babies: Cultural beliefs of Vietnamese mothers about maternal health, infant feeding and infant growth

Tran Thi Giang Huong, Susan Furber, Jane Allen, Nguyen Dinh Nguyen, and Maurice Eisenbruch  (Department of International Cooperation, Ministry of Health, Vietnam; James Fairfax Institute of Paediatric Nutrition, The Children’s Hospital at Westmead, Westmead, Australia)
 
Background: Studies of infant feeding show the profound importance of maternal beliefs regarding milk, but less attention has been paid to the impact of beliefs about normal growth and development in relation to nutrition of the baby. This study aimed to examine the cultural beliefs about maternal health, infant feeding practices and infant growth held by the Vietnamese mothers residing in Australia.
Method: Qualitative data were gathered from in depth interviews and participant observation of 20 Vietnamese mothers in  South wWestern Sydney. Narrative analysis was used to identify the themes and patterns, such as maternal nutrition during pregnancy and after delivery, infant feeding practices, sources of information and support, and beliefs about a healthy baby
Results: The special dietary and care during pregnancy and after delivery, driven by beliefs about the hot-cold balance of their body and the thickness of the informants’ milk of women in our study, were similar to those adhered to by women in Vietnam and among emigrants to other countries. Infant feeding patterns differed, however: in Vietnam, infants are breast-fed and introduced to solids early, whereas in Australia they were breast-fed for a shorter duration and introduced to formula but introduced to solids later. Beyond that, cultural beliefs about the association between the hot-cold status (not really mentioned as status) of the mother, diet and the thickness of the breast milk played a critical role. Maternal monitoring of their babies’ development – and need for milk – had more to do with perceived behaviour and mental development than weight gain. The beliefs about the balance of body humors continue to exert influence on women long after they have begun to acculturate.
Discussion: Traditional beliefs need to be identified and utilized in promoting breast-feeding. The findings may inform culturally competent practice in paediatrics and obstetrics, and for nutrition and primary health.

Childhood psychosocial problems and disorders and local treatments in Cambodia

Eisenbruch, M.
1997-99NHMRC. $34,000, $22,000, $37,000